Marketing: Why the Conversation Has Changed — Forever

At its core, pharmaceutical marketing is about conversations. Dynamic, persuasive conversations between companies and healthcare professionals, their patients, and other stakeholders that have become critical to today's process of marketing a pharmaceutical product and meeting a patient's needs.

One time it was simple. Now it's not.

Al Topin

Patients had illnesses and diseases. Pharmaceutical companies developed compounds that helped healthcare professionals treat those diseases. They would tell physicians about their new compounds through conversations with sales representatives, advertising in medical journals, and medical meetings. The physicians wrote prescriptions for those compounds, and their patients did what they were told.

Marketing was sort of simple: understand the unmet need and how the compound filled that need, (i.e., the science behind it), communicate it clearly and cleverly to the physician, and success ensued. Marketing managers and advertising agencies thrived.

It used to be simple. Now it is not, and it never will be again. In fact, it's going to get harder, much harder.

Today's unmet needs can no longer be filled by just a drug

Pharmaceutical market dynamics have become much more complex, requiring conversations with multiple parties at multiple levels. Medical science has become increasingly more detailed, regulation has added layers and barriers, payers look at the benefits of a new drug with a more critical financial eye, and physicians barely have the time to thoroughly diagnose their patients' illnesses, much less talk with the patients themselves. And today's patients no longer salute the doctor's white coat, take two pills, and call back in the morning. Today, patients take charge of their own healthcare, do their own research, ask questions, and challenge the prescribed course of treatment.

Meeting an unmet need has expanded from the use of a new drug to unraveling the complexity of information and information resources, unwinding the barriers of payers' restrictions, and communicating with the many new voices that have entered the conversation. Patients have caregivers and spouses; physicians have nurse practitioners, physician assistants, and multilayered office staffs; and the local family pharmacist has jumped in to fill the missing link between patients and their time-challenged medical providers (hence the combination of terms–Pharm-Assist).

Pharmaceutical marketing has turned ugly

Conversations have moved beyond dynamic to chaotic. Competitive battles take place in medical waiting rooms, formulary committee meetings, office sample closets, and subtly but forcefully between scientific presentations at medical meetings and FDA review committees.

So on top of the almost one billion dollars required to bring a molecule to commercialization, today's pharmaceutical manufacturer has to add even more funds to find the right path to market and create clear, dynamic, and persuasive conversations with all of the new influencers in today's medical marketplace. Compared to this new set of pharmaceutical market dynamics, even today's Hollywood movie business doesn't look so high risk.

Drafting the new conversation

Frankly, developing the new conversation is not that different from developing the old...but there are a lot more moving parts and more pitfalls. Here are the basics.

Listen to the market. Yeah, we already know that. We listen all the time. We sit behind a one-way mirror and listen. But to whom? And to what? Does the doctor understand our position? Like our graphic? Is he or she persuaded by our concept? Good information, but not the only insights we must have today.

Newsweek reports that over the last 10 years, the number of patients in a primary care practice has grown from over 1,800 to as many as 3,000. And Consumer Reports says that 70 percent of doctors reported that since they began practicing medicine, the bond with their patients has eroded. Doctors simply have no time left to spend with their patients, but we want them to prescribe our new molecule with complex dosing, a long side-effect profile, and a serious REMS program. This changes things. If our new molecule is going to succeed, our conversation has to provide solutions to multiple unmet needs and focus on the right healthcare professional in the doctor's office who has the time to help. Nurse practitioner? PA? Now listen harder to their specific unmet needs.

Listen at the patient level, too. Nearly 10,000 baby boomers turn 65 years old each day. And just as they have done for the housing, furniture, and carpet business, they are walking into physician's offices armed with information, questions, and a commitment to control their own healthcare destiny. Physicians without time now meet patients with a long list of needs and their Medicare cards in hand. How's your marketing program going to deal with that? A few new insights are called for.

Focus. Gather your insights. Isolate the key issues. Now focus like a laser beam. Create a clear strategy that eliminates the extras, conserves your resources, and keeps you from jumping on your horse and riding in all directions. With so much work to do, so many new audiences to reach and persuade, and so many new channels of communication, it's essential to remember that strategy comes first, not tactics. Not the latest digital thing you want to try. Clear, focused strategy comes first to create a launch path through a cluttered, noisy market. If you are redefining a new category within an existing market, all your efforts in all your conversations should be focused on that point. Sales reps, thought leaders, and MSLs should all be focused on the same point. It seems obvious, but when you're in a meeting with medical affairs, sales training, regional directors, R&D, and marketing, the obvious is often uninvited.

Map it out. We all think we know our market, until we step back and see how much it's changed. If we follow step one and listen to the market, we should be able to literally draw a map of it—whom we are having our conversations with, what unmet needs exist, where we can have the most impact, where the patient becomes part of the conversation, what drives the moment of truth when the prescription is written, where the pharmacist fits in, and what their role is in the conversation.

Now stand back, look at the map, and begin your planning process, with a realistic picture of the market and with your customers in mind.

Align the message and position. Let's go back to that crowded room with medical affairs, sales training, regional directors, R&D, marketing, and probably a few other entitled departments discussing the launch plan. If you asked them to stand up right now, single out their key customer, and outline their conversation, how many would be singing from the same hymnal? Would they be speaking clearly, concisely, persuasively, and in harmony? Not if you haven't aligned all of their messages with the position. Medical sees the science story a bit differently than R&D. Sales tells it their way, and the regional director from Europe wants to bend a bit here and there. And while the label keeps them together, their varying points of view create gaps that can weaken the message.

The science, information, and messaging must be aligned with the position to maximize a budget that most likely will be stretched to the limit. Building a science bridge across all departments and silos is critical to the efficiency and effectiveness of the brand's launch message. Start by crafting a message/conversation matrix which creates the science bridge and aligns each component of the product's story with each audience, and make sure that each group approves and sticks with it. If a message czar needs to be appointed, make sure that senior management endorses it from on high.

Build the tools. Throw out the standard tactic list and start over. Go back to your market map and message matrix and isolate the key communications challenges that each audience has been communicating with each other. Now gather the marketing/communications team and work through the best tools to get your message across. Do you need a 32-page sales aid or maybe four different tools that help the sales rep start a conversation on four different calls? Can you bring a thought leader into the conversation with an iPad video? Can you review a case study and leave behind a flash card or trifold? Would a video about newly diagnosed patients help a nurse address her patients' initial concerns?

No rules, just targeted conversations. Dynamic, customized conversations that drive a unified message to each stakeholder.

Just when you think you've got it mastered...

There are only a few constants in our business. There will always be patients with medical needs, and there will always be innovative companies that will create molecules, processes, and devices to treat those needs. As to how they communicate with the marketplace to tell them what they offer, how to use it, and how best to acquire it—that will forever be in flux. And the savvy marketer will need to keep a critical eye on the market, listening to the conversations and remapping the relationships and pathways. Because it's not just about the drug anymore.

Al Topin is President of Topin & Associates, and a member of Pharm Exec's Editorial Advisory Board. He can be reached at atopin@topin.com.